MEDICARE: BROWN-FOLSE RADIOLOGY GROUP, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275584856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROWN-FOLSE RADIOLOGY GROUP, LLC

Provider Business Mailing Address
First Line	:	1240 RICHARDSON RD
Second Line	:
City	:	CALHOUN
State	:	LA
Zip	:	71225-9440
Country	:	US
Telephone Number	:	210-389-2338
Fax Number	:	210-614-7103

Provider Business Practice Location Address
First Line	:	1240 RICHARDSON RD
Second Line	:
City	:	CALHOUN
State	:	LA
Zip	:	71225-9440
Country	:	US
Telephone Number	:	210-389-2338
Fax Number	:	210-614-7103

Authorized Official
Title or Position	:	CEO
Name	:	CRAIG P. FOLSE
Credential	:	M.D.
Telephone Number	:	318-644-4401

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	10/20/2016

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